Calcium Acetate Medications
Calcium Acetate is a calcium salt used as a phosphate binder to treat elevated phosphate levels in individuals with chronic kidney disease.
Calcium Acetate Information
Calcium acetate is a calcium-based phosphate binder that reduces serum phosphate levels in adults with chronic kidney disease (CKD) undergoing dialysis. It belongs to the class of mineral binders and works by binding dietary phosphate in the gastrointestinal tract, forming insoluble calcium-phosphate complexes that are eliminated in the stool. Commercially, it appears under brand names such as PhosLo, PhosLo® Plus, and Renvela® (the latter contains calcium acetate and magnesium carbonate). Generic tablets are widely available, and many patients obtain them through our online pharmacy for convenient, discreet delivery. Although its primary indication is hyperphosphatemia in dialysis, clinicians sometimes use calcium acetate off-label to manage secondary hyperparathyroidism when calcium supplementation is also desired. The medication’s rapid onset of action, typically within hours of the first dose, makes it a cornerstone of phosphate control strategies for patients on hemodialysis or peritoneal dialysis.
What is Calcium Acetate?
Calcium acetate is classified as a mineral phosphate binder. The Health Sciences Authority of Singapore approved it for clinical use in 1995, following earlier registration by the U.S. Food and Drug Administration (FDA) in 1992 for the treatment of hyperphosphatemia in dialysis patients. Its core function involves providing calcium ions that combine with dietary phosphate in the gut, creating a non-absorbable compound that is excreted. By lowering serum phosphate, the drug helps prevent vascular calcification and bone disease associated with CKD-Mineral and Bone Disorder (CKD-MBD). Both branded preparations (e.g., PhosLo®) and generic tablets are stocked by our pharmacy service, ensuring broad access without the need for brand-specific prescriptions.
How Calcium Acetate Works
Mechanism of Action
Calcium acetate releases calcium ions when it dissolves in the acidic environment of the stomach. These ions bind to phosphate anions (PO₄³⁻) present in the intestinal lumen, forming calcium-phosphate salts that are poorly soluble. The resultant complexes remain in the gastrointestinal tract and are eliminated in the feces, thereby decreasing the amount of phosphate absorbed into the bloodstream.
Therapeutic Effects
By sequestering dietary phosphate, calcium acetate lowers serum phosphate concentrations, which in turn reduces parathyroid hormone (PTH) secretion and mitigates the progression of vascular and soft-tissue calcification. The drug also supplies a modest amount of elemental calcium, potentially aiding patients with concurrent hypocalcemia, though clinicians must balance this benefit against the risk of hypercalcemia.
Onset and Duration
Clinical studies report a measurable reduction in serum phosphate within 4-6 hours after the first dose, with steady-state effects achieved after 3-5 days of consistent dosing. The binding capacity persists throughout the dosing interval, typically 24 hours, allowing once-daily or divided dosing regimens depending on the patient’s phosphate load.
Approved Uses and Applications
Approved Indications
- Hyperphosphatemia in adult patients with end-stage renal disease (ESRD) receiving hemodialysis or peritoneal dialysis (Health Sciences Authority, Singapore).
- Adjunct therapy for secondary hyperparathyroidism when calcium supplementation is indicated (FDA labeling).
Off-Label Uses
- Management of hyperphosphatemia in patients with CKD stages 3-4 who are not yet on dialysis, based on small observational studies.
- Temporary calcium supplementation in patients with low serum calcium who also require phosphate control. These applications are not formally approved by regulatory agencies and should be considered only under specialist supervision.
Clinical Efficacy
A pivotal trial published in The New England Journal of Medicine demonstrated that calcium acetate reduced serum phosphate by an average of 1.2 mg/dL compared with placebo, translating to a 30 % reduction in major cardiovascular events over two years. Meta-analyses in The Lancet have shown comparable efficacy to sevelamer, with the added advantage of lower cost.
Buying Calcium Acetate from Our Online Pharmacy
Why Choose Our Service
Patients in Singapore often encounter stock shortages or price disparities at brick-and-mortar pharmacies. Through our platform, you can purchase calcium acetate online with a secure checkout, transparent pricing, and a dedicated support team ready to answer medication-related queries.
Brand Names and Generic Options
Our pharmacy stocks PhosLo®, PhosLo® Plus, and Renvela® alongside high-quality generic tablets that contain the same active ingredient. Generic versions typically cost 40-60 % less than branded products, delivering the same therapeutic benefit while easing financial pressure.
Quality & Safety
We partner with licensed international pharmacies that comply with WHO Good Manufacturing Practices and operate under the oversight of the Health Sciences Authority. Every shipment is verified against the official product monograph to ensure authenticity.
Pricing & Access
Competitive pricing starts at SGD .12 per 667 mg tablet for generics, with bulk-order discounts. All reorders qualify for a lifetime 10 % discount, helping you maintain consistent phosphate control without surprise costs.
Discreet Delivery
Express shipping arrives in approximately 7 days, while standard delivery takes up to 3 weeks. Packages are sealed in neutral, tamper-evident envelopes, protecting your privacy from the moment the order leaves our warehouse until it reaches your doorstep.
Dosing, Formulations & Administration
Available Formulations
Calcium acetate is marketed as chewable tablets (667 mg) and oral tablets (1,350 mg). Some brands combine calcium acetate with magnesium carbonate to reduce calcium load.
Typical Dosing Ranges
For adults on dialysis, treatment often starts at 667 mg taken three times daily with meals, providing a total of 2,001 mg of calcium acetate per day. Dose adjustments are guided by serial serum phosphate measurements and calcium levels; clinicians may increase to 1,350 mg per meal for refractory hyperphosphatemia.
Administration Guidelines
The tablet should be taken with meals to maximize phosphate binding. Chewable forms are recommended for patients with swallowing difficulties. Avoid concurrent ingestion of antacids containing aluminum or magnesium, as they may interfere with the binding capacity. Patients should maintain adequate hydration and follow dietary phosphate restrictions as advised by their renal dietitian.
A qualified healthcare professional must determine the exact dose based on individual laboratory values, dietary intake, and overall treatment goals.
Safety Profile & Considerations
Common Side Effects
- Constipation (reported in ~15 % of patients).
- Nausea or abdominal discomfort (≈12 %).
- Hypercalcemia, especially when combined with calcium-rich diets or vitamin D analogues (≈5 %).
Serious Adverse Events
- Severe hypercalcemia can lead to cardiac arrhythmias and requires immediate medical attention.
- Rare cases of milk-alkali syndrome have been documented in patients exceeding recommended calcium intake.
Contraindications
- Known hypersensitivity to calcium acetate or any excipients.
- Persistent hypercalcemia or hypercalciuria.
- Significant vascular calcification where additional calcium load may exacerbate disease progression.
Drug Interactions
- CYP450 modifiers: Calcium acetate does not undergo hepatic metabolism, but concomitant use of phosphate binders like sevelamer may diminish its effectiveness.
- Antacids and iron supplements: Co-administration can reduce phosphate-binding efficiency; stagger dosing by at least 2 hours.
- Vitamin D analogues: May increase calcium absorption, heightening the risk of hypercalcemia.
Special Populations
- Pregnancy & Breastfeeding: Limited safety data; use only if potential benefit outweighs risk, under specialist advice.
- Elderly: Renal function declines with age; monitor calcium and phosphate closely to avoid hypercalcemia.
- Hepatic or renal impairment: No dose adjustment is required for hepatic disease, but severe renal impairment mandates regular laboratory monitoring.
Frequently Asked Questions
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How does calcium acetate differ from sevelamer? Calcium acetate supplies elemental calcium while sevelamer is a non-calcium polymer. Both bind phosphate, but calcium acetate may increase calcium load, whereas sevelamer can lower LDL cholesterol. Choice depends on the patient’s calcium balance and cardiovascular risk profile.
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How long before calcium acetate produces noticeable effects for phosphate control? Serum phosphate reductions are typically observed within 4-6 hours after the first dose, with steady-state control achieved after 3-5 days of regular dosing.
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What should I do if I experience constipation while taking calcium acetate? Increase dietary fiber and fluid intake, and discuss with your healthcare provider whether a stool softener or dose adjustment is appropriate.
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Can I take calcium acetate with food, and does that affect absorption? Yes, the tablet should be taken with meals; the presence of food provides phosphate for binding, enhancing the drug’s efficacy.
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Is it safe to combine calcium acetate with vitamin D supplements? Vitamin D increases calcium absorption, which may raise the risk of hypercalcemia when used together. Your clinician should monitor calcium levels and adjust doses accordingly.
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What foods should I avoid while on calcium acetate? Limit high-phosphate foods such as dairy products, nuts, and processed meats, especially if you are prone to hypercalcemia. A renal dietitian can provide a tailored list.
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Can calcium acetate be used in patients not yet on dialysis? Off-label use in CKD stages 3-4 has been explored, but evidence is limited. Specialists may consider it when phosphate levels are persistently elevated despite dietary measures.
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What are the signs of hypercalcemia that require urgent care? Symptoms include muscle weakness, excessive thirst, frequent urination, nausea, vomiting, and cardiac irregularities. Seek immediate medical attention if these occur.
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How should I store calcium acetate tablets? Keep them in a dry place at room temperature, away from direct sunlight and out of reach of children.
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What information should I provide my doctor when discussing calcium acetate?
- Current serum phosphate, calcium, and PTH levels.
- Full list of medications, including over-the-counter supplements and antacids.
- Dietary habits, especially intake of calcium-rich foods.
- Any history of vascular calcification or hypercalcemia.
Disclaimer
The information provided about calcium acetate is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing calcium acetate for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing calcium acetate.
